JCM, Free Full-Text
Por um escritor misterioso
Last updated 23 maio 2024
Background: The optimal indication, dose, and timing of corticosteroids in sepsis is controversial. Here, we used reinforcement learning to derive the optimal steroid policy in septic patients based on data on 3051 ICU admissions from the AmsterdamUMCdb intensive care database. Methods: We identified septic patients according to the 2016 consensus definition. An actor-critic RL algorithm using ICU mortality as a reward signal was developed to determine the optimal treatment policy from time-series data on 277 clinical parameters. We performed off-policy evaluation and testing in independent subsets to assess the algorithm’s performance. Results: Agreement between the RL agent’s policy and the actual documented treatment reached 59%. Our RL agent’s treatment policy was more restrictive compared to the actual clinician behavior: our algorithm suggested withholding corticosteroids in 62% of the patient states, versus 52% according to the physicians’ policy. The 95% lower bound of the expected reward was higher for the RL agent than clinicians’ historical decisions. ICU mortality after concordant action in the testing dataset was lower both when corticosteroids had been withheld and when corticosteroids had been prescribed by the virtual agent. The most relevant variables were vital parameters and laboratory values, such as blood pressure, heart rate, leucocyte count, and glycemia. Conclusions: Individualized use of corticosteroids in sepsis may result in a mortality benefit, but optimal treatment policy may be more restrictive than the routine clinical practice. Whilst external validation is needed, our study motivates a ‘precision-medicine’ approach to future prospective controlled trials and practice.
Magnatone Slash Signature Collection SL-412 - Slash 4x12 Cabinet - Peach Guitars
Author Instructions - AIP Publishing LLC
General Instructions, Journal of Computer-Mediated Communication
JMH Mummy Font Download
Marshall JCM 800 MK2 Master Model 100w Lead 1986
JCAMP-DX format mass spectrum file for 2 chlorophenol
JCM, Free Full-Text
Central service technical manual : Free Download, Borrow, and Streaming : Internet Archive
Des Blood Vr Death Marine - Colaboratory
Recomendado para você
-
Gordon Hayward - Charlotte Hornets Small Forward - ESPN23 maio 2024
-
Golden State Warriors Eye 6th-Straight Win – Sofascore News23 maio 2024
-
Sportske novosti - Zubac odradio dobar posao protiv Jokića, Leonard zamalo preokrenuo! Denver sve bliže vrhu Zapada23 maio 2024
-
Frontiers Randomized Controlled Study Evaluating Efficiency of Low Intensity Transcranial Direct Current Stimulation (tDCS) for Dyspnea Relief in Mechanically Ventilated COVID-19 Patients in ICU: The tDCS-DYSP-COVID Protocol23 maio 2024
-
Dončić i Mavsi preživjeli Ballov triple-double, Cavsi dobili Warriorse - N123 maio 2024
-
CD209L/L-SIGN and CD209/DC-SIGN Act as Receptors for SARS-CoV-223 maio 2024
-
Game Thread: Miami Heat (12-10) at Charlotte Hornets (7-13) Dec 11 2023 7:00 PM : r/CharlotteHornets23 maio 2024
-
PT-20201222) A Bola, PDF, Times de futebol23 maio 2024
-
Irving in Dončić zrežirala zmago proti Utahu23 maio 2024
-
Genetic Factors of the Disease Course after Sepsis: A Genome-Wide Study for 28Day Mortality - eBioMedicine23 maio 2024
você pode gostar
-
Kaiko sareta Ankoku Heishi v2 by Pikri4869 on DeviantArt23 maio 2024
-
Intelligence Agency - Roblox23 maio 2024
-
Lily on X: New item with effects coming soon! This MM2 Crown might be the new Prime Gaming item for Dec, which means there will probs be an in-game item too? #Roblox #23 maio 2024
-
Lolbit pfp in 2023 Fnaf sister location characters, Fnaf sister23 maio 2024
-
Vegan Vallarta: Puerto Vallarta's Veg Scene - Chic Vegan23 maio 2024
-
Vk Food Point Fast Food - blog grandchef23 maio 2024
-
Not My Job: The Blue Man Group Turns 25 : NPR23 maio 2024
-
Spread Love Everywhere You Go Print Stock Illustration 145031134723 maio 2024
-
Solved 4Lak hou ane given the basehand sienals h wir ams or23 maio 2024
-
Lote com Seis Brinquedos Pokemon23 maio 2024